Overview
Tooth decay is a permanent damage caused by acid produced by bacteria in the mouth, eroding the tooth surface (enamel) and then the dentin. It is one of the most common chronic diseases in the world; approximately 90% of adults experience tooth decay at least once.
In early stages it does not cause pain; therefore regular dental check-ups are very important. If left untreated, it can lead to tooth loss and serious infections.
Symptoms
As decay progresses, symptoms appear:
- Tooth sensitivity to hot, cold, or sweet
- Toothache (especially when eating)
- Visible hole or stain on the tooth
- White, brown, or black spots on the tooth surface
- Bad breath
- Food getting stuck between teeth
- Facial swelling in advanced cases (abscess)
- Gum inflammation around the tooth
Causes
Decay results from the combination of 4 factors:
- Susceptible tooth surface
- Plaque bacteria (especially Streptococcus mutans)
- Sugary and starchy foods
- Time (duration of acid attack)
Bacteria digest sugar and produce acid. This acid erodes the enamel; repeated acid attacks break through the enamel and reach the dentin.
Risk Factors
- Poor oral hygiene (irregular brushing, no flossing)
- Frequent sugary and starchy consumption (especially constant snacking)
- Sugary drinks, soda, fruit juices
- Sticky, acidic foods
- Dry mouth (low saliva)
- Fluoride deficiency
- Age (high risk in children and the elderly)
- Tooth structure problems
- Acid reflux
- Some eating disorders (anorexia, bulimia)
- Some medications (causing dry mouth)
- Teeth grinding
Complications
- Severe toothache
- Dental abscess (pus collection)
- Tooth loss
- Difficulty chewing
- Nutrition problems (especially in children)
- Speech problems
- Spread of infection (sinuses, jaw bone, even brain)
- Life-threatening Ludwig's angina
- Systemic effects (heart valve inflammation)
When to See a Dentist
- Toothache
- Sensitivity to hot/cold
- Visible cavity or hole
- Swelling on the face or under the jaw
- Tooth fracture
- Persistent bad breath
- Routine check-up: Visit your dentist every 6 months
Diagnosis and Treatment
Diagnosis: Visual examination and dental X-ray.
Treatment (according to depth of decay):
- Early stage (enamel): Fluoride treatment can strengthen enamel
- Filling: Composite (white) or amalgam filling
- Crown: For large cavities
- Root canal treatment: When decay reaches the nerve
- Tooth extraction: For teeth that cannot be saved
- Implant or bridge: To replace lost teeth
Prevention
Dental care:
- Brush twice a day (morning and evening) for 2 minutes
- Use fluoride toothpaste
- Floss once a day
- You can use antibacterial mouthwash
- Learn proper brushing technique
Nutrition:
- Limit sugary foods and drinks
- Avoid snacking throughout the day
- Stay away from sticky sweets
- Drink plenty of water
- Eat a diet rich in calcium and vitamin D
Regular check-ups:
- Visit the dentist every 6 months
- Have professional cleaning
- Fissure sealants may be applied to children
- Benefit from fluoride treatment
- Do not delay early cavities